Abdominal, multi-port and single-port total laparoscopic hysterectomy: eleven-year trends comparison of surgical outcomes complications of 936 cases

Abstract

Our study showed that MPA-TLH and SPA-TLH were feasible and safe when compared to TAH. Furthermore, after acquiring technical skills in laparoscopic surgery, conversion from MPA-TLH to SPA-TLH might be easier than the initial conversion from laparotomy to laparoscopy. The advantage of SPA-TLH over MPA-TLH is questionable, considering the longer learning curve; however SPA-TLH is an effective alternative for both the patient and surgeon.

Laparoendoscopic single-site surgery versus conventional laparoscopy for hysterectomy: a systematic review and meta-analysis

“…The initial search yielded 668 unique references, and twenty-three studies fulfilled our inclusion criteria. Eleven studies compared LESS hysterectomy to conventional TLH [13, 20–29], eleven studies compared LESS hysterectomy to LAVH [30–40], and in one study, both procedures were included [41]. Two studies also included supra-cervical hysterectomies [20, 21].…”

“…A total of 1985 women in the LESS group and 2466 women in the conventional hysterectomy were included in six randomized controlled trials [23, 24, 26, 30, 39, 41], five prospective cohort studies [21, 27, 32, 36, 37], and 12 retrospective cohort studies [13, 20, 22, 25, 28, 29, 31, 33–35, 38, 40]. Twenty of the studies (86.9%) were performed in Asia (fifteen in Korea [13, 23–25, 27, 28, 31, 32, 34–39, 41], one in China [26], two in Japan [29, 40], and two in Taiwan [30, 33]), and the other three studies originated from the United States [20], Italy [22], and France [21]. Fourteen studies had a single center design [20–24, 26–30, 33, 36, 37, 39], one RCT was multi-center, and in the other eight studies, the setting was unclear [13, 25, 31, 32, 34, 35, 38, 40].…”

“…Twenty of the studies (86.9%) were performed in Asia (fifteen in Korea [13, 23–25, 27, 28, 31, 32, 34–39, 41], one in China [26], two in Japan [29, 40], and two in Taiwan [30, 33]), and the other three studies originated from the United States [20], Italy [22], and France [21]. Fourteen studies had a single center design [20–24, 26–30, 33, 36, 37, 39], one RCT was multi-center, and in the other eight studies, the setting was unclear [13, 25, 31, 32, 34, 35, 38, 40]. …”

“…Fifteen studies stated that there was no potential conflict of interest to disclose [13, 20–27, 30–33, 35, 38], five studies reported financial support (from a grant of Samsung Medical Center [39], from a grant of Korea Health Care technology [36, 37], from Covidien [41], and from Kyung Hee University Research Fund [34]), and three studies remained unclear about their potential conflicts [28, 29, 40]. …”

“…In some parts of the world, single-port hysterectomy seems well implemented. A retrospective single-hospital study from Korea showed for example that in 2013, 80% of their hysterectomies were LESS hysterectomies [13]. Hysterectomy in general is one of the most performed advanced surgeries in gynecology with approximately 600,000 procedures a year in the United States [11].…”